How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $134.90 | Professional | None | $93.33 | $134.90 | $134.90 |
BCBS Alabama Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
BCBS Alabama Setting Professional Modifier 12 + 31 + 32 · Mandated service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 12 + 31 + 32 · Mandated service | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | None | $102.33 | $102.33 | $117.49 |
United Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $186.21 | Professional | None | $81.28 | $107.15 | $186.21 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $14.13 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $13.49 | $13.49 |
Where Alabama sits
The same service costs 3.0 times more in Alaska than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Alabama· 10th of 51
$151
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.